| NPI | 1508841248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008235) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 008235) |
| 363A00000X Physician Assistant (Licence: AZ 3224) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-12-01 |