| NPI | 1275901589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3981) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018939) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2017-03-08 |