| NPI | 1598889875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD c005098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010291) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2016-10-12 |