| NPI | 1093001638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 014863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014863) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-10-04 |