| NPI | 1821647090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3321) |
| 363AM0700X Physician Assistant Medical (Licence: SC 3321) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2023-08-22 |