| NPI | 1497888614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19543) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 1499) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-12-05 |