| NPI | 1942334115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4397) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 009878) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2017-04-12 |