| NPI | 1811160559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 012498) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2024-04-30 |