| NPI | 1164478954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 005462) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NY 005462-1) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-10-31 |