| NPI | 1619217601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22785) |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2023-06-20 |