| NPI | 1851312284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 19102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0109191) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-09-09 |