| NPI | 1003295197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024596) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09957) |
| 363A00000X Physician Assistant (Licence: KY TC380) | |
| 363A00000X Physician Assistant (Licence: IL 085009169) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2024-09-24 |