NPI | 1053907279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59746) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-12-13 |
Last Update Date | 2023-07-17 |