| NPI | 1477902955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53450) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0005131) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2018-08-07 |