| NPI | 1356593503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA20668) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20668) | 
| Enumeration Date | 2008-10-21 | 
| Last Update Date | 2021-01-15 |