| NPI | 1164870853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019949) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 19949) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-06-29 |