| NPI | 1588968739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020344) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NY 626340-1) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2016-11-04 |