| NPI | 1245436534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016556) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 124925) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2023-05-12 |