| NPI | 1184970048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022249-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA AT002076) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2018-11-27 |