| NPI | 1386186302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 55484) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 02034949-1) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2021-01-21 |