| NPI | 1962944041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059751) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020195) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2020-08-30 |