| NPI | 1073115697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63779) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001010873) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-10-28 |