| NPI | 1619078417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4379) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006356) |
| 363A00000X Physician Assistant (Licence: NC 0010-12067) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-01-25 |