| NPI | 1508405259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 02898801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61014089) |
| Enumeration Date | 2019-12-29 |
| Last Update Date | 2022-11-16 |