| NPI | 1215058409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011201-1) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA031053) | 
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2014-09-02 |