| NPI | 1457800377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021905) |
| 363A00000X Physician Assistant (Licence: PA MA058491) | |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2023-08-30 |