| NPI | 1437793494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062286) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 024390) |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2023-06-16 |