| NPI | 1699128686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59051) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019830-1) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2022-04-07 |