| NPI | 1710543194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57475) |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2025-10-20 |