| NPI | 1982900502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21912) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014377) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2019-05-10 |