| NPI | 1740675586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 031859) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 0004148) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-09-13 |