| NPI | 1235793852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9116212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024116) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-08-02 |