| NPI | 1144663105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1892) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016122) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2018-10-23 |