| NPI | 1659504207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013477) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 013477-1) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2020-06-09 |