| NPI | 1588063424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51767) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017893) |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2018-01-04 |