| NPI | 1497312763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024127) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2021-12-08 |