| NPI | 1487846630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 004019-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 003806) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 004019-1) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2023-05-12 |