| NPI | 1003883943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9104660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010412-1) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2015-12-08 |