| NPI | 1467905232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9116683) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 019721-1) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2024-10-10 |