| NPI | 1124667563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024568-01) |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2024-06-12 |