| NPI | 1255723797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024382) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 10313257) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2021-02-02 |