| NPI | 1538755905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14231) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026108) |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2024-06-19 |