| NPI | 1649676396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6032) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018074) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2021-03-30 |