| NPI | 1568537405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C08704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008845) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2023-04-27 |