| NPI | 1457977944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026506-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061470) |
| 363A00000X Physician Assistant (Licence: PA OA005209) | |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2021-11-29 |