| NPI | 1861579369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1661) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010719) |
| 207Q00000X Family Medicine (Licence: SC TL1661) | |
| 207P00000X Emergency Medicine (Licence: SC TL2661) | |
| 363A00000X Physician Assistant (Licence: SC TL1661) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-05-13 |