| NPI | 1770756918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 012279) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 12279) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2023-07-06 |