NPI | 1023736022 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61974) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-08-16 |
Last Update Date | 2022-11-22 |