| NPI | 1912443086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA54204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023479) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2023-03-07 |