| NPI | 1679279467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031305) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16286) |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2024-07-26 |