| NPI | 1669628947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012695) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2017-04-12 |