| NPI | 1043889470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64913) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11360) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2024-10-01 |