| NPI | 1811025257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 003700) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CT 000463) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2018-06-15 |