| NPI | 1093368144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 023628) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11877) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2023-06-21 |