| NPI | 1023619129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025874) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2023-05-11 |