| NPI | 1467975219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1142010) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2022-04-04 |