| NPI | 1497893044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 006515) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008524) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2021-05-05 |