| NPI | 1093945792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55934) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013380) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2020-06-17 |