| NPI | 1245267368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005381) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 5381) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-07-05 |