| NPI | 1679244503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10745) |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2024-03-26 |