| NPI | 1083280648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026736) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2023-11-15 |