| NPI | 1689712614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 002458-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 069338) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA-000169-L) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2021-06-10 |