| NPI | 1124337050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004501) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 013555) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2024-07-09 |