| NPI | 1609861079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA11833) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA pa-11833) |
| 363A00000X Physician Assistant (Licence: CA PA11833) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2024-07-08 |