| NPI | 1104387448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA60834) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 023260) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-01-04 |