| NPI | 1538836630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13866) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027544) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2024-02-22 |