| NPI | 1669489233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015404-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0030719) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-01-11 |