| NPI | 1770139859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 15004) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |