| NPI | 1972873388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 014689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 14689) |
| 363A00000X Physician Assistant (Licence: NY 014689) | |
| 363A00000X Physician Assistant (Licence: MA PA4310) | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2023-06-29 |