| NPI | 1437792132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 029210) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2024-12-02 |