NPI | 1104351469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54959) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-04-25 |
Last Update Date | 2023-06-01 |