| NPI | 1124168745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 008209) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052932) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2010-08-27 |