NPI | 1376056531 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55146) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 55146) |
Enumeration Date | 2017-11-09 |
Last Update Date | 2023-10-30 |