| NPI | 1457709263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019701) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-05-09 |