| NPI | 1225042443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005198-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0000081) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-03-10 |