| NPI | 1154620797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028949) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 28949) |
| 363A00000X Physician Assistant (Licence: MA PA4147) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2023-07-22 |