| NPI | 1902134216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015364) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054237) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2015-11-09 |