| NPI | 1164706537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23 015185) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2023-12-07 |