| NPI | 1750445979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012587-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051256) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-05-07 |