| NPI | 1659547834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 15513) |
| 363A00000X Physician Assistant (Licence: OH 50.002647) | |
| 363AM0700X Physician Assistant, Medical (Licence: MD C0002909) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2023-07-17 |