| NPI | 1437446234 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 014827)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006872)  | 
| 363A00000X Physician Assistant (Licence: NJ 25MP00274900)  | |
| Enumeration Date | 2011-06-30 | 
| Last Update Date | 2019-01-08 |