| NPI | 1518208867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 016342-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 0163421) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2023-07-27 |