| NPI | 1356712053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019227) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA58339) |
| 363A00000X Physician Assistant (Licence: IL 085007456) | |
| 363A00000X Physician Assistant (Licence: TX PA13204) | |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2024-11-21 |