| NPI | 1518336346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019066) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7461) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2024-01-17 |