| NPI | 1538168067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54269) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105108) |
| 363AM0700X Physician Assistant, Medical (Licence: SC A447) | |
| 363AS0400X Physician Assistant, Surgical (Licence: SC 447) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2019-10-25 |