| NPI | 1295755312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4991) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011038) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-03-18 |