| NPI | 1598775298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15410) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104128) | 
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2009-11-18 |