| NPI | 1144841396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PS00583) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026091-01) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2022-04-29 |