| NPI | 1831495241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014464) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2014-08-13 |