| NPI | 1316723570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030968) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA065286) |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2024-01-24 |