| NPI | 1720642812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63080) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7026) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-06-10 |