| NPI | 1376161620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027724) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: ME PA2413) | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2024-12-10 |