| NPI | 1992085757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05301) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 014981) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2023-03-30 |