| NPI | 1225674765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024471) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2021-11-16 |