| NPI | 1821393000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014440) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2023-03-07 |