| NPI | 1831692375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59402) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06760) |
| 363A00000X Physician Assistant (Licence: VA 0110006041) | |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2023-10-09 |