| NPI | 1992054456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015940) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2024-10-04 |