| NPI | 1295342566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-12285) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 025693) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2024-07-15 |