| NPI | 1598933715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058895) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012361) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2019-08-23 |