| NPI | 1922521160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9115412) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021021-1) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-03-01 |