| NPI | 1609527746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027834) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2025-02-03 |