| NPI | 1821493230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 53716) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5614) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2016-11-15 |