| NPI | 1871745133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY P67542) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 013067) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2011-11-14 |