| NPI | 1962932301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7705) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55057) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2024-04-18 |