| NPI | 1346673456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C06396) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016782-1) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2021-09-28 |