| NPI | 1710205521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53266) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054386) |
| 363A00000X Physician Assistant (Licence: NY 013708) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2024-02-06 |