| NPI | 1487785721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013141) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 515) |
| 363A00000X Physician Assistant (Licence: AZ 2369) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2009-02-19 |