| NPI | 1043785553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023043-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005757RX) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2021-12-14 |