| NPI | 1255779450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 028006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA23070) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA23070) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-05-11 |