| NPI | 1508240086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 18660) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2023-06-28 |