| NPI | 1942429584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 000062-1) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-11-12 |