| NPI | 1760446801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 007048) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0070481) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2008-10-22 |