| NPI | 1740259373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001408L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 004188-1) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2021-03-01 |