| NPI | 1427309095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9109425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016029) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2023-01-16 |