| NPI | 1730362260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 14105) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA 14105) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2009-01-23 |