| NPI | 1982840328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020744) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20143) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2022-07-21 |