| NPI | 1841529781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019447) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304977-1) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2016-06-23 |