| NPI | 1154832293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021644) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2021-04-16 |