| NPI | 1467716902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004240) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015661) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2023-11-21 |