NPI | 1386390524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60972) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-02-25 |
Last Update Date | 2022-10-24 |