| NPI | 1609428598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 57109) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-12-29 |