| NPI | 1104499136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027399) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 111918-01) |
| 363A00000X Physician Assistant (Licence: NY 267826) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-10-18 |