| NPI | 1902114408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 014260) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1393) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2020-07-21 |