| NPI | 1144912593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64623) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9470) |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2025-01-23 |