| NPI | 1407185747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7880) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22958) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2020-12-18 |