| NPI | 1659554715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 51219) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05724) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 3757) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2020-02-20 |