| NPI | 1023356193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4307) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016312) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2024-06-14 |