| NPI | 1649523218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51257) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004902) |
| 363A00000X Physician Assistant (Licence: VA 0110004030) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA51257) | |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2024-02-12 |