| NPI | 1821771288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA67469) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2026-07-07 |