| NPI | 1811918345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 008886-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00180) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-03-10 |