| NPI | 1528143393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22580) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007716) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2014-05-23 |