| NPI | 1255834099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 021881) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA8739) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 60222) | |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085.008386) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2024-03-18 |