| NPI | 1154741742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019177) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005391) |
| 363AM0700X Physician Assistant, Medical (Licence: OH 004019) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 19177) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2023-06-29 |