| NPI | 1962638569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 16940) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA16940) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2022-07-08 |