| NPI | 1477657971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA15523) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA15623) |
| 363A00000X Physician Assistant (Licence: CA PA15623) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2024-03-21 |