| NPI | 1700101367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL1517) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017208) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2014-01-02 |