| NPI | 1992121321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017383-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056777) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2015-12-01 |