| NPI | 1912673039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60629) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2023-09-30 |