| NPI | 1558690560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60522) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053996) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2022-04-06 |