| NPI | 1184936833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05906) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2020-06-02 |