| NPI | 1801121561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5133) |
| 363A00000X Physician Assistant (Licence: NY 017370) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2024-01-17 |