| NPI | 1003239765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017068-1) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2014-12-11 |