NPI | 1568846046 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA53305) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 9383625-1206) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2019-02-11 |