| NPI | 1518409481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020317-1) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2019-09-10 |