| NPI | 1972384394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63815) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2025-08-23 |