| NPI | 1528598067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112241) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-01-17 |