| NPI | 1518362649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA54604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.60500171) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2024-10-08 |