| NPI | 1578533949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3697) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010666-1) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-10-23 |