| NPI | 1477957926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 60414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52743) |
| 363A00000X Physician Assistant (Licence: NY 018039-1) | |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2024-02-19 |