| NPI | 1194259192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006440) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020758-1) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2022-08-09 |