| NPI | 1104372689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-14543) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 020014-1) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2024-12-19 |