| NPI | 1396356796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61516) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10862) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2024-02-01 |