| NPI | 1275941411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017801) |
| 363A00000X Physician Assistant (Licence: MA PA6336) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 017801) | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2023-12-08 |