| NPI | 1992854780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 1066480) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010530) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-11-21 |