| NPI | 1750554515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 013193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY P63329) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2017-08-28 |