| NPI | 1962525113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA14380) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 67564) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2015-08-04 |