| NPI | 1265986897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA53804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109868) |
| 363A00000X Physician Assistant (Licence: NY 025982-01) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2024-06-27 |