| NPI | 1285282624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 338096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 1851895) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2023-10-02 |