| NPI | 1033592183 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 018758)  | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2015-07-08 | 
| Last Update Date | 2022-01-21 |