| NPI | 1912202631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1818) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NY 02750) | |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2024-12-27 |