| NPI | 1104328699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023714-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11832) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2019-10-06 |