| NPI | 1750666210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003710) |
| 363A00000X Physician Assistant (Licence: AZ 6622) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2022-03-07 |