| NPI | 1396185609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053902) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018631-1) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2015-12-14 |