| NPI | 1336703941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: CA PA58548) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2023-11-10 |