| NPI | 1861980591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 55523) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 19176) |
| 183500000X Pharmacist (Licence: CA 58789) | |
| 183500000X Pharmacist (Licence: AZ S015988) | |
| 363A00000X Physician Assistant (Licence: AZ 7100) | |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2020-06-03 |