| NPI | 1497819395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 043071) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2025-01-23 |