| NPI | 1780308890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA68135) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 031446) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2026-06-28 |