| NPI | 1841430261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA3774) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013132) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-07-21 |