| NPI | 1013430594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059198) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021023-1) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-03-04 |