| NPI | 1669848297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA68163) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61527272) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2026-06-09 |