| NPI | 1255737946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018174) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2022-03-04 |