| NPI | 1104221258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 52064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52064) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2025-03-14 |