| NPI | 1457872509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12475) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-01-26 |