| 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 |