| NPI | 1922362284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA52903) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015668) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2020-02-10 |