| NPI | 1275592578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0063861) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-02-15 |