| NPI | 1659571024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA13993) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA13993) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA13993) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-12-13 |