| NPI | 1295359123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10454) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025040) |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2022-03-14 |