| NPI | 1265762173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08902) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013763-1) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2023-03-07 |