| NPI | 1083071948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019435-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019435) |
| Enumeration Date | 2016-01-24 |
| Last Update Date | 2019-07-01 |