| NPI | 1851532493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011689) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: NY 013182) | |
| 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011689) | |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2022-05-06 |