| NPI | 1891756482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 000632) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 300488) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2010-01-27 |