| NPI | 1669455234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 007760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 7760) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-07-05 |