| NPI | 1508484858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025609) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2023-11-21 |