| NPI | 1629354055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 57209) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106908) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2022-03-22 |