| NPI | 1215456231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58176) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021277) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2023-07-11 |