| NPI | 1821481797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057507) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018505) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2017-04-13 |