| NPI | 1679766653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC applied) |
| 207P00000X Emergency Medicine (Licence: NY 010017) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2009-08-13 |