| NPI | 1508245366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022970) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT005682) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: NY 1146529) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2023-03-31 |