| NPI | 1386249712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065331) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024982) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2024-04-05 |