| NPI | 1609020791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 308563) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MA 4717) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 308563) | |
| Enumeration Date | 2008-11-16 |
| Last Update Date | 2023-07-07 |