| NPI | 1730119439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 011238) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011238) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-09-22 |