| NPI | 1578700712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58396) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013544) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2020-10-14 |