| NPI | 1114534963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 025610) |
| 363A00000X Physician Assistant (Licence: NY 025610) | |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2021-12-22 |