| NPI | 1093264152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020189) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2022-05-03 |