| NPI | 1689067084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53257) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23 018503) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2020-07-22 |