| NPI | 1922869700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64932) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-10-20 |