NPI | 1104498757 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59566) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-07-13 |
Last Update Date | 2022-06-23 |