| NPI | 1437502754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23 019887) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2022-04-27 |