| NPI | 1952572315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11075) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011362) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2022-12-06 |