| NPI | 1578199527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62951) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8466) |
| 363A00000X Physician Assistant (Licence: CT 4942) | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2023-11-18 |