| NPI | 1902897333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 104106) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2022-07-07 |