| NPI | 1619170768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MA055459) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 003026-1) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA055459) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-07-15 |