| NPI | 1750864773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55972) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09673) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2020-08-18 |