| NPI | 1063765022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 16139) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2023-07-07 |