NPI | 1578222154 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60892) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-12-11 |
Last Update Date | 2022-12-27 |