| NPI | 1114126695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029290) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MA053007) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2023-10-18 |