NPI | 1902270986 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA53048) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 53048) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2019-09-12 |