| NPI | 1114994159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 003615) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 3615) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2023-07-05 |