| 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 |