| NPI | 1659681161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 1095702) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA006088) |
| 363A00000X Physician Assistant (Licence: FL 9113706) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2024-08-02 |