| NPI | 1891553632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00849100) |
| 363A00000X Physician Assistant (Licence: NY 031570) | |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-10-09 |