| NPI | 1588817399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012923) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2023-08-01 |