| NPI | 1548557499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22230) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2496) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2021-10-06 |