| NPI | 1417411349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4258) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA60130) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-09-04 |