| NPI | 1053263640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA67811) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: CA PA67811) |
| Enumeration Date | 2026-02-13 |
| Last Update Date | 2026-02-13 |