| NPI | 1265441992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010397) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001610) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-09-09 |