| NPI | 1598287401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011608) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY processing) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2021-10-06 |