| NPI | 1164852216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017206) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 017206) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2014-09-16 |