| NPI | 1952395956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 005915-1) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 005195-1) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2016-01-11 |