| NPI | 1588139091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55882) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 55882) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2020-06-03 |