| NPI | 1710654587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59700) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 59700) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2023-01-19 |