| NPI | 1417279449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 013749) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 13749) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2023-07-03 |