| NPI | 1154034916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 029374) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 029374) |
| Enumeration Date | 2022-12-26 |
| Last Update Date | 2023-03-11 |