| NPI | 1639475130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008611) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013988) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2025-01-10 |