| NPI | 1881795722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 010246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13202) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-01-07 |