| NPI | 1568951606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008473) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55869) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2023-03-07 |