| NPI | 1891911558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8043) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006334) |
| 106H00000X Marriage & Family Therapist (Licence: NY P103134) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-01-05 |