| NPI | 1265868434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA23210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107360) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2014-09-15 |