| NPI | 1255420964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 0026511) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F000326-1) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-10-16 |