| NPI | 1215455795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021359) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54885) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2019-10-08 |