| NPI | 1023427838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51822) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2017-06-02 |