| NPI | 1588921282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006412) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059343) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 015466-1) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2019-12-30 |