| NPI | 1700323888 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60246)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020585)  | 
| 363A00000X Physician Assistant (Licence: AZ 9234)  | |
| Enumeration Date | 2017-01-26 | 
| Last Update Date | 2024-01-29 |