| NPI | 1225014798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57807) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011028) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-02-18 |