| NPI | 1417390857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015964-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004865) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-03-16 |