| NPI | 1649753187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-013950) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022445) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2024-12-18 |