| NPI | 1356673404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008718-1) |
| Enumeration Date | 2010-01-31 |
| Last Update Date | 2025-03-27 |