| NPI | 1023232659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011750) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2010-09-14 |