| NPI | 1508314592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021981) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10765) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2019-03-27 |