| NPI | 1619140068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 12193) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2023-07-06 |