| NPI | 1992453195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62506) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2616) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2024-05-30 |