| NPI | 1043464415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012960) |
| 363A00000X Physician Assistant (Licence: IA 002310) | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2014-11-20 |