NPI | 1518680925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64912) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-09-21 |
Last Update Date | 2025-07-14 |