| NPI | 1487731048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0000813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 001281-1) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-01-15 |