| NPI | 1790146058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023162) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 201600578) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2024-04-04 |