| NPI | 1851470215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2081) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2081) |
| 363A00000X Physician Assistant (Licence: NY 010521) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL 9105236) | |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2014-04-23 |