| NPI | 1255589040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 23 012723) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 12723) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2023-07-06 |