| NPI | 1104449461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61090) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2282) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2023-01-26 |