| NPI | 1376639856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010771) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 10771) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-07-05 |