| NPI | 1396275970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020947-1) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-11-26 |