| NPI | 1922428465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 008795) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017516) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2022-02-23 |