| NPI | 1598198426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016823) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2023-12-19 |