| NPI | 1497212484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 026627) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 45876) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2023-11-28 |