| NPI | 1649812090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0009982) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2025-09-11 |