| NPI | 1699248187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025064-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005738RX) |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2022-02-15 |