| NPI | 1215330709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118242) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017838) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2024-08-22 |