| NPI | 1336611631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3760) |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2023-03-07 |