| NPI | 1518291640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA21866) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013474) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2011-12-19 |