| NPI | 1275221921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 029012) |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2023-04-28 |