| NPI | 1194311852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 58983) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 1179343) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-05-29 |