| NPI | 1982366993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14214136-1206) |
| 363A00000X Physician Assistant (Licence: UT 14214136-8906) | |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2026-07-01 |