| NPI | 1144557554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062487) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013677) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2022-11-02 |