| NPI | 1730657131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9112268) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0228831) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2023-01-11 |