| NPI | 1003825241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011537) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051446) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-08-16 |