| NPI | 1154473502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 011610) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011610) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-08-17 |