| NPI | 1134452717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013578) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 13578) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2023-07-06 |