| NPI | 1639602378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55253) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006433) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2018-10-04 |