| NPI | 1528659984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA59071) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-07-27 |