| NPI | 1962586354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1765) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011082) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-04-29 |