| NPI | 1073925640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA17250) |
| Additional Taxonomies | 261QA0006X Clinic/Center, Ambulatory Fertility Facility (Licence: CA PA 17250) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2021-05-18 |