| NPI | 1801349774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59311) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: DE C5-0001080) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2021-05-19 |