| NPI | 1134536675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056986) |
| 363A00000X Physician Assistant (Licence: PA OA003346) | |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2016-10-27 |