| NPI | 1649311630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011050) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 011050) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2016-03-30 |