| NPI | 1558902494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA66543) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2026-08-11 |