| NPI | 1508261256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 53653) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2018-05-17 |