| NPI | 1407254162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 52294) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057237) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2022-10-12 |