| NPI | 1376787747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 009157-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009157) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2018-02-13 |