| NPI | 1053439562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009551-1) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-08-11 |