| NPI | 1154350551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 0027181) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1932) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 103890) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2015-02-24 |