| NPI | 1841581147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 304341) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2021-12-03 |