| NPI | 1700940137 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18329) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA 18329) | 
| Enumeration Date | 2006-12-20 | 
| Last Update Date | 2021-12-15 |