| NPI | 1215313218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3585-23) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2022-05-11 |