| NPI | 1275770497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029895) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052418) |
| 363A00000X Physician Assistant (Licence: MA PA100031) | |
| 363AM0700X Physician Assistant, Medical | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA052418) | |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2024-02-05 |