| NPI | 1174175939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003038A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023646) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2020-09-08 |