| NPI | 1033597075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7515) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018526-1) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2020-08-26 |