| NPI | 1710492814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 55227) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2019-02-11 |