| NPI | 1487088688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016795) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009459) |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2021-04-06 |