| NPI | 1497127278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019239) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2020-11-17 |