| NPI | 1134960321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA67216) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2025-11-18 |