| NPI | 1396790523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9109467) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA14129) |
| 363A00000X Physician Assistant (Licence: NY 003825) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-08-09 |