| NPI | 1669872354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51830) |
| Additional Taxonomies | 171W00000X Contractor (Licence: CA 51830) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2025-08-28 |