| NPI | 1346277092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3018) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010932) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2018-09-06 |