| NPI | 1316561798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025200) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2020-06-02 | 
| Last Update Date | 2021-05-17 |