| NPI | 1043734288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13456) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-10-25 |