| NPI | 1114980729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00096900) |
| 363A00000X Physician Assistant (Licence: GA 004835) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2023-03-22 |