| NPI | 1669728655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015785) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 7041) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2022-01-22 |