| NPI | 1750753141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52982) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 52982) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2023-09-21 |