| NPI | 1760947543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023128) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-02-05 |