| NPI | 1083761308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023960) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NY 024627) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2019-10-10 |