| NPI | 1730427071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058352) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016285) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2016-08-26 |