| NPI | 1114132057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3764) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011827) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-06-09 |