| NPI | 1548626237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7027) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0193571) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2019-07-07 |