| NPI | 1356578603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005145) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024723) |
| Enumeration Date | 2009-06-14 |
| Last Update Date | 2021-05-03 |