NPI | 1073132718 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64566) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00709) |
Enumeration Date | 2020-04-13 |
Last Update Date | 2024-10-16 |