| NPI | 1508377847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6829) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA60501) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2022-03-17 |