| NPI | 1750832531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.60705011) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2021-09-01 |