| NPI | 1710728688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 67325) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 67325) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-12-03 |