| NPI | 1033282728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005055) |
| 363A00000X Physician Assistant (Licence: AK 488) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-03-07 |