| NPI | 1659847309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA66508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006867) |
| Enumeration Date | 2018-10-21 |
| Last Update Date | 2026-01-07 |