| NPI | 1669675419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA pa17916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008171) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-11-22 |