| NPI | 1457018996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 029476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062940) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2023-06-27 |