| NPI | 1497229108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA57108) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2023-11-15 |