| NPI | 1295213684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 022369) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059987) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2024-09-23 |