| NPI | 1407160484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014052) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2025-01-17 |