| NPI | 1033685136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 10808) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022697) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2023-07-11 |