| NPI | 1336158328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18304) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA18304) |
| 363AS0400X Physician Assistant Surgical (Licence: CA PA18304) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2023-03-07 |