NPI | 1235492299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22620) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
Enumeration Date | 2012-06-24 |
Last Update Date | 2024-01-11 |