NPI | 1497492920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 61501) |
Enumeration Date | 2022-05-16 |
Last Update Date | 2024-10-02 |