| NPI | 1548563695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60109) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014531) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2026-01-27 |