| NPI | 1447523865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011517) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 005986) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2014-01-30 |