| NPI | 1891212809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005845) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-01-03 |