| NPI | 1821360702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA22007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22007) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2021-11-23 |