| NPI | 1528360724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21258) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007847) |
| 363A00000X Physician Assistant (Licence: CA 21258) | |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2020-06-10 |