| NPI | 1639546914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 52678) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52678) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2022-02-11 |