| NPI | 1508036617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA 18285) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 1035691) |
| 363AM0700X Physician Assistant Medical (Licence: CA PA18285) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2023-08-17 |