| NPI | 1710329503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA51618) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005062) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2016-11-29 |