| NPI | 1942452149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63860) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22735) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 002119) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 019968) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2024-03-16 |