| NPI | 1629463088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL pa9115076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52266) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-10-31 |