| NPI | 1952563843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013296) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY P65540) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2020-01-15 |