| NPI | 1073089371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022831) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 22831) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2023-06-30 |