| NPI | 1881239267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-2455) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026034) |
| Enumeration Date | 2019-11-09 |
| Last Update Date | 2023-04-26 |