| NPI | 1316496904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 3075) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 23 019954) |
| Enumeration Date | 2016-09-24 |
| Last Update Date | 2016-09-24 |