| NPI | 1538141494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 008591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008591) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-10-13 |