| NPI | 1477107498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028279) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 8560) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2022-12-01 |