| NPI | 1831238997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 009902) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: ME PA001265) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-06-14 |