| NPI | 1669663274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4879) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2024-08-07 |