| NPI | 1467541060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA 3742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 001910) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2011-12-14 |