| NPI | 1710113873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013245) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2018-08-09 |