| NPI | 1346559440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014249) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2020-07-09 |