| NPI | 1366747230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2185) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013251) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2018-03-17 |