| NPI | 1982220745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA62572) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-10247) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2023-07-06 |