NPI | 1730531708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA64086) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2016-07-01 |
Last Update Date | 2024-04-11 |