| NPI | 1104226919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005240) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017903-1) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2024-03-19 |