| NPI | 1326142001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051782) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 005210-1) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2014-04-24 |