| NPI | 1699045823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA22028) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 9963) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2022-11-28 |