| NPI | 1053576660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA pa20430) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012522) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2010-11-16 |