| NPI | 1730712191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025077) |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2023-07-10 |