| NPI | 1497436422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63086) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 63086) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 63086) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-09-19 |