| NPI | 1053697557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015268-1) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2025-08-15 |