| NPI | 1558505628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013421-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003933) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2017-04-09 |