| NPI | 1558616474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015682-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015682-1) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2021-12-02 |