| NPI | 1255725842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA65842) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2014034082) |
| 363A00000X Physician Assistant (Licence: AZ 8142) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2025-06-10 |