| NPI | 1851657241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 56953) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-03282) |
| 363AM0700X Physician Assistant Medical (Licence: AL PA-1193) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2019-10-30 |