| NPI | 1144892225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110009039) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027368) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2023-06-19 |