| NPI | 1518276302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003366) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 014174-1) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2025-06-09 |