NPI | 1881880912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19323) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical | |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2007-09-21 |
Last Update Date | 2025-04-15 |