| NPI | 1003002643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 12048) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2023-07-06 |