| NPI | 1457492159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 001089-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 330451) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |