| NPI | 1063552099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011390) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04306) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2024-10-28 |