| NPI | 1801880778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 010419-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18431) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2011-04-19 |