| NPI | 1881076677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8527) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018699) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2022-06-30 |