NPI | 1750884391 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 62527) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1331) |
Enumeration Date | 2018-03-09 |
Last Update Date | 2024-02-28 |