| NPI | 1073916201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 17657) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2024-05-10 |