| NPI | 1356881965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020832) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 20832) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2024-01-30 |