| NPI | 1366996241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4240) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020004) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2022-05-09 |