| NPI | 1225416472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020919) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA5343) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2020-07-02 |