| NPI | 1285934562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 014424-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004218) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2019-05-16 |