| NPI | 1063641009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008617-1) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-10-01 |