| NPI | 1538516430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55165) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 55165) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 019680) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2024-02-12 |