| NPI | 1003094616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011936) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2010-02-24 |