| NPI | 1871017541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56714) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021087-1) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2023-12-01 |