| NPI | 1508599150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 028437) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 28437) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2023-07-17 |