| NPI | 1659325975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009178) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-10-26 |