| NPI | 1144493578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 012487) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 059737) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2014-10-06 |