| NPI | 1154865913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021987) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54082) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2022-02-24 |