| NPI | 1215235429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020304-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020304) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2018-09-27 |