| NPI | 1457406035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19857) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 004571) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2019-06-13 |