| NPI | 1568414969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54680) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110840820) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-03-17 |