| NPI | 1366869158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1159) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017461) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2016-04-28 |