| NPI | 1033116124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 007997) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 007997) |
| 363A00000X Physician Assistant (Licence: NY 007997-1) | |
| 363A00000X Physician Assistant (Licence: MA PA9342) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2024-01-17 |