NPI | 1356593503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA20668) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20668) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2021-01-15 |