| NPI | 1750002390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 029088) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2024-07-15 |