| NPI | 1164434965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 016504) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC A354) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 101592) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-03-23 |