| NPI | 1851722573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60431997) |
| 363A00000X Physician Assistant (Licence: AZ 8707) | |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2023-02-16 |