| NPI | 1528317047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51565) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015907) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2016-07-01 |