| NPI | 1114177870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026211) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001042A) |
| 363A00000X Physician Assistant (Licence: NY 26211) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2023-07-07 |