| NPI | 1063458347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 5086621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 6498) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-07-05 |