| NPI | 1639840028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11597) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA61823) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2026-03-09 |