| NPI | 1629481262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA51626) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-04-08 |