| NPI | 1588623367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001002915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010268-1) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-08-26 |