| NPI | 1831793587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 1182118) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2021-02-09 |