| NPI | 1457792954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016711) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2022-10-27 |