| NPI | 1104333178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 329541-1) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2023-01-21 |