NPI | 1508416207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63239) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-09-14 |
Last Update Date | 2024-01-02 |