NPI | 1417284233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 15470) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA 15470) |
Enumeration Date | 2009-11-16 |
Last Update Date | 2020-06-19 |