| NPI | 1770977340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55208) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5611) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-01-17 |