| NPI | 1174823876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA21949) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9105750) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2015-10-26 |