| NPI | 1639802564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA61644) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA61644) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2025-11-19 |