| NPI | 1104009026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 012326) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 12326) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2023-07-03 |