| NPI | 1235545542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56583) |
| 363A00000X Physician Assistant (Licence: PA MA056968) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-01-25 |