| NPI | 1578959987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56757) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018416-1) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-05-21 |