| NPI | 1548929094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027939) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2022-04-14 |