| NPI | 1063594224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10453) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009284) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-12-27 |