| NPI | 1013303593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057498) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-12-13 |