| NPI | 1669457552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 15145) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA15145) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2014-06-18 |