| NPI | 1538229679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05119) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051464) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA000867) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 014480) | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 2509) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-03-07 |