| NPI | 1073550703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010658-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06662) |
| 363A00000X Physician Assistant (Licence: NY 10658) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-07-03 |