| NPI | 1942787783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8077) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022285-1) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2021-01-15 |