| NPI | 1477104073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023949) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006721) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |