| NPI | 1740385822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 006523) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 6523) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-07-05 |