| NPI | 1407463144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01702) |
| 363A00000X Physician Assistant (Licence: MA PA101031) | |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2024-09-16 |