| NPI | 1386294296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7810) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 1168538) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2022-02-24 |