| NPI | 1871103382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12366) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 025406) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2022-10-03 |