| NPI | 1265628580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011923) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 11923) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2023-06-29 |