| NPI | 1477807089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06457) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016172) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2022-11-14 |