| NPI | 1053147017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA68328) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065922) |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2026-06-09 |