| NPI | 1912390428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027484) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7519) |
| Enumeration Date | 2015-03-07 |
| Last Update Date | 2023-10-20 |