| NPI | 1902359607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 53585) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA 53585) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |