| NPI | 1306104203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4908) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2022-08-30 |