| NPI | 1154821452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 021826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021826) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2022-07-26 |