| NPI | 1508955634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 16151) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV 2827) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 16151) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-08-04 |