| NPI | 1609305184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020826) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2023-09-14 |