| NPI | 1508124017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026577) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000003330) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-04-11 |