| NPI | 1619306230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058557) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017175) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2023-03-09 |