| NPI | 1518276302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 014174-1) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2012-06-27 |