| NPI | 1942866165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025787) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2023-03-13 |