| NPI | 1487958377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008250) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020346-1) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2023-04-13 |