| NPI | 1194889386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 008185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 8185) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2023-04-28 |