NPI | 1396163945 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 51531) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2021-09-02 |