| NPI | 1902373095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS PA00673) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: CA PA56628) | |
| 207Q00000X Family Medicine (Licence: CA PA56628) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA56628) | |
| Enumeration Date | 2018-10-27 |
| Last Update Date | 2022-09-26 |