| NPI | 1093187445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057948) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 22809) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2023-07-03 |