| NPI | 1073561072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA21422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008989) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-08-09 |