| NPI | 1972924561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017412) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2016-01-16 |