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 |