| NPI | 1194121525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018030) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 18030) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2023-05-15 |