| NPI | 1477215978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12803) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027279) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2024-04-18 |