| NPI | 1467938274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4962) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022212) |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2023-12-11 |