| NPI | 1821387937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015437-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4050) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2013-12-02 |