| NPI | 1316566094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7968) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2023-11-29 |