| NPI | 1023782869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065460) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026975) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2024-05-29 |