| NPI | 1386922292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C04520) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 21187) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2023-06-29 |