| NPI | 1386052371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 55458) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PAT9107943) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2021-05-14 |