| NPI | 1902055650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012566) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 012566) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2017-03-16 |