| NPI | 1972775328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-00834) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical (Licence: CA 60726) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2024-12-06 |