| NPI | 1154853588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021942-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54330) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-05-26 |