| NPI | 1881091569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018577-01) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601007217) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2021-06-09 |