| NPI | 1073688255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 18176) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 011462) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2016-02-09 |