| NPI | 1578672564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 0032531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 3253) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-07-03 |