| NPI | 1275517716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 001091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F330065) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2007-07-08 |