| NPI | 1366623928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012228-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3839) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2010-06-07 |