| NPI | 1245401207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053796) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012223-1) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2015-12-17 |