| NPI | 1841709276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA54657) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54657) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 54657) | |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2023-11-27 |