| NPI | 1629596481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60775825) |
| 363A00000X Physician Assistant (Licence: PA MA062210) | |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2023-12-07 |