| NPI | 1568850162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 002016-1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 000260) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2016-11-09 |