| NPI | 1427482868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA ma058202) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016830) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-11-16 |