| NPI | 1588434922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA67515) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA67515) |
| 363A00000X Physician Assistant (Licence: CA PA67515) | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2026-05-04 |