| NPI | 1457825705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11736) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023132) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2022-10-26 |