| NPI | 1699134254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57573) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019314) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-07-12 |