| NPI | 1780168864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022622) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2022-10-12 |