| NPI | 1205514056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030375-01) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-08-30 |