| NPI | 1679809008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6548) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013656) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2022-02-25 |