| NPI | 1992354526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64080) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09404) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2024-12-04 |