| NPI | 1891119020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53880) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017355) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2022-07-21 |