| NPI | 1649679606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 017835) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 17835) |
| 363A00000X Physician Assistant (Licence: NY 23 017835) | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2023-04-28 |