NPI | 1386248011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59725) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA59725) |
Enumeration Date | 2020-11-23 |
Last Update Date | 2023-10-03 |