| NPI | 1235145905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 004180-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F300536-1) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-12-18 |