| NPI | 1578546669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005940) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-12-06 |