| NPI | 1225220163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20227) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 002981) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2018-02-09 |