| NPI | 1467769646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 1070571) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014036) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2011-11-07 |