| NPI | 1629242235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 010016) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 10016) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2023-07-06 |