NPI | 1124666938 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57812) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-12-12 |
Last Update Date | 2021-03-01 |