| NPI | 1295201713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023101) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 023101) | |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2024-12-20 |