| NPI | 1396762076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA17578)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA17578)  | 
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2025-05-14 |