| NPI | 1629685326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025682) |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2023-06-23 |