| NPI | 1982254173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060993) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 027863) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2024-04-30 |