| NPI | 1174670673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2282) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016155-1) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-02-18 |