| NPI | 1417256363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9116250) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014679) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2023-09-06 |