| NPI | 1972146090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57728) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2021-07-23 |