| NPI | 1760608533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008784) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-12-07 |