| NPI | 1366847709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9847) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0181291) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2020-08-27 |