| NPI | 1518372200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017590) |
| Enumeration Date | 2014-06-22 |
| Last Update Date | 2024-08-23 |