| NPI | 1720868045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA63007) |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2025-03-02 |