| NPI | 1568784635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62453) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C04759) |
| 363A00000X Physician Assistant (Licence: PA MA054311) | |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2023-03-23 |