| NPI | 1083939680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8208) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007347) |
| 363AM0700X Physician Assistant Medical (Licence: NY 007347) | |
| 363AS0400X Physician Assistant Surgical (Licence: NY 007347) | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2023-08-17 |