| NPI | 1528344876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 53167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61155425) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9106285) | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2024-06-13 |