| NPI | 1164617700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19268) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 19268) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2022-02-11 |