| NPI | 1073589693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001022L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 002552-1) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2008-03-28 |