| NPI | 1386920445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015197) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2017-12-11 |