| NPI | 1275621500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006095) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061516) |
| 363A00000X Physician Assistant (Licence: NY 007610) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-03-10 |