| NPI | 1487133369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C007644) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022447) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2023-05-10 |