| NPI | 1720506744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57931) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07710) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2023-08-03 |