| NPI | 1972327773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 12586) |
| Enumeration Date | 2024-11-09 |
| Last Update Date | 2024-11-16 |