| NPI | 1649989468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 67016) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: 1188440) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2026-09-22 |