| NPI | 1528211331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA22920) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054431) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02002) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA002840) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2013-10-08 |