| NPI | 1245880913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024030) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 24030) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2023-06-30 |