| NPI | 1013084763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 6403-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 6403-1) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-08-02 |