| NPI | 1427483874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016906) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2021-03-24 |