| NPI | 1669060562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-2540) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 58792) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2023-09-13 |