| NPI | 1265191209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027682) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2022-03-25 |