NPI | 1780935445 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53197) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002925) |
363A00000X Physician Assistant (Licence: PA MA055752) | |
Enumeration Date | 2012-09-20 |
Last Update Date | 2024-05-08 |