| NPI | 1316255631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 020834) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054921) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2023-08-31 |