| NPI | 1720092042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05388) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 9380) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2022-08-19 |