| NPI | 1861403867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: NY 000616-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 0006161) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-03-12 |