| NPI | 1801338512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020397) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2023-05-15 |