| NPI | 1376639872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 006216) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 6216) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-07-03 |