| NPI | 1336220383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002312L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 0057681) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-10-11 |