NPI | 1750920609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64729) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-12-24 |
Last Update Date | 2025-08-05 |