| NPI | 1659937456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OR PA213429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 23973) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2023-07-17 |