| NPI | 1679535124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013186) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00318) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2009-12-07 |