| NPI | 1770292773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029157) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12715) |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2024-06-17 |