| NPI | 1265716369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017515) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003681) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2016-10-19 |